An analysis of the Avon Longitudinal Study of Parents and Children data found that children with hyperacusis at age 11 tended to show more severe symptoms of anxiety when they were 13 and 16 years old. The association remained even when controlling for pre-existing anxiety and emotional problems, autism traits, and other neurodiversity characteristics such as ADHD, dyslexia, or dyspraxia. The paper was published in the Journal of Child Psychology and Psychiatry.
Hyperacusis is a condition in which ordinary sounds feel unusually loud, uncomfortable, painful, or overwhelming. Sounds that most people tolerate easily, such as dishes clinking, traffic, voices, music, or household appliances, may feel unbearable to someone with hyperacusis. It is different from simply disliking noise, because the person’s sound tolerance is reduced.
Hyperacusis can affect one or both ears. It may occur after noise exposure, ear problems, migraine, head injury, certain neurological conditions, anxiety, or sometimes without a clear cause. Some people with hyperacusis also have tinnitus, which means hearing ringing, buzzing, or other sounds without an external source. The condition can lead people to avoid social situations, public places, work environments, or everyday activities. Interestingly, using ear protection all the time can sometimes make sound sensitivity worse, although such protection is useful in environments that are genuinely loud.
Study author Foteini Tseliou and her colleagues wanted to assess whether a single question about hyperacusis at age 11 helps predict anxiety and related emotional problems in adolescence (ages 13 and 16). They also wanted to know whether it can distinguish previously identified developmental trajectories of anxiety.
These authors analyzed data from the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC is an ongoing longitudinal study that initially enrolled 14,541 pregnant women residing in the Avon area in the UK who expected delivery between April 1991 and the end of 1992. They gave birth to 14,062 children, 13,988 of whom reached 1 year of age.
Data used in this analysis came from 6,621 participants of the ALSPAC study. Fifty-one percent of them were female. They answered a question about hyperacusis when they were 11 years old and provided data on mental health outcomes of interest for this analysis at least once after this. These outcomes were emotional problems at 13 and 16 years of age; anxiety, depression, and self-harm at 24; and emotional problems at 25 years of age.
When participating children were 11 years old, they attended a hearing assessment during which a hyperacusis and tinnitus interview was also carried out. One of the questions asked them whether they ever experienced oversensitivity or distress to particular sounds, referring to everyday sounds, not sounds that were particularly loud. The authors of this study used responses to this question as a measure of hyperacusis.
Results showed that 3.7% of participating children reported hyperacusis. Sixty-two percent of the children reporting hyperacusis were boys. Analyses showed that children who reported hyperacusis at age 11 had three times higher odds of reporting hyperacusis when they were 28 years old.
Further analyses revealed that children who suffered from hyperacusis at 11 years of age tended to show more severe symptoms of anxiety when they were 13 and 16 years old. This association remained even when accounting for pre-existing anxiety or emotional problems, autism traits, and other neurodiversity characteristics such as ADHD, dyslexia, or dyspraxia. Specifically, the researchers noted that hyperacusis was most strongly associated with symptoms of fear, worry, and nervousness, rather than broader depressive symptoms or somatic complaints.
Hyperacusis at 11 years of age also predicted a persistent trajectory of anxiety development. This trajectory refers to children whose anxiety-related emotional problems were already high in childhood and remained high throughout childhood and adolescence, rather than decreasing over time. Additional analyses found that hyperacusis still predicted emotional problems when participants were 25 years old, but did not predict adult generalized anxiety disorder, major depressive disorder, or suicidal self-harm.
“Taken together, our findings suggest that assessing hyperacusis at age 11 can provide additional predictive insights into the exacerbation and maintenance of anxiety in adolescence,” the study authors concluded.
The study contributes to the body of scientific knowledge about the mental health correlates of hyperacusis. However, the study authors note that the ALSPAC study experienced substantial dropout over time, with over 50% of participants dropping out of the study by 24 years of age. This could have introduced attrition bias, affecting the results. Furthermore, measuring hyperacusis with a single question asked during a formal hearing clinic may have led to underreporting, as some children might not have realized the question applied to everyday distress over normal noises.
The paper, “Sensory hyperacusis as a predictor of anxiety in adolescence,” was authored by Foteini Tseliou, Stephan Collishaw, Alice Price, and Petroc Sumner.
